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Bharti AXA Health Insurance

Commenced in August 2008, the company works in collaboration between Bharti Enterprises with 74% share and AXA with remaining 26% share. Bharti enterprise is one of the renowned business corporations in India. Whereas, Bharti Axa is a global financial and wealth management company.

Bharti AXA General Insurance owns 59 corporate offices in India. In the initial years of operation, the company received ISO 9001:2008 certification, followed by an ISO 27001:2005. It is one of the most trusted and emerging insurance companies. Bharti AXA health insurance is known for its dedicated services, smooth customer relationships and hassle-free claim process. Customer reviews for the insurer also reflect positively.

Bharti AXA Health Insurance Plan Overview:

Key Features Highlights
Incurred Claim Ratio 86.84%
Network Hospitals 4300+
NCB Discount on Renewal 5%
Tax Benefits Under Section 80D
Pre-existing diseases waiting period 4 years

Features of Bharti AXA Health Insurance

  • Covers Pre & Post hospitalization expenses– It compensates the medical expenses incurred 30 days before the hospitalization and after 60 days of the hospitalization as mentioned in the policy documents
  • Lifelong renewability – Bharti AXA mediclaim plan offers lifetime coverage and gives you the option of lifetime renewability.
  • Free health-check-ups – In case of 4 claim-free years, 1 percent of the sum insured is offered for free health check-ups.
  • No Capping on Room Rent – There is no capping on room rent in certain health plans.
  • Coverage of Pre-existing Illnesses– After 4 years of the policy term, it also covers the pre-existing diseases.
  • Smart Medical Plans for Senior Citizens– Bharti AXA mediclaim policy for senior citizens offers comprehensive coverage to elderly parents up to Rs. 1cr.

Bharti AXA Health Insurance Plans Comparison Table

Features           Smart Super Health Insurance Plan Smart Health Insurance Plan
Plan type Value Classic Uber
Sum Insured (Rs.) 5 & 7 lakhs 10,10 &20 lakhs 20 lakhs to 1 crore 3, 4 & 5 lakhs
Pre-Hospitalization Up to SI for 60 days Up to SI for 60 days Up to SI for 60 days Up to SI for 30- to 40 days
Post-hospitalization Up to SI for 90 days Up to SI for 90 days Up to SI for 90 days Up to SI for 60 days
Room Rent Up to Sum assured Up to Sum assured Up to Sum assured Basis of the plan
Restoration of Sum Insured Up to 100 percent of SI Up to 100 percent of SI Up to 100 percent of SI N/A
AYUSH Treatment Up to the sum insured limit Up to the sum insured limit Up to the sum insured limit Up to the sum insured limit
Day Care Treatment Up to the sum insured limit Up to the sum insured limit Up to the sum insured limit Up to the sum insured limit
Domiciliary Hospitalization Up to the sum insured limit Up to the sum insured limit Up to the sum insured limit 10% of sum insured
Organ Donor Expenses Up to SI Up to SI Up to SI 10% of SI, if SI is 3 and 5 lakhs.  15% of SI if opted for a 4 lakh plan (in case of critical illness).
Maternity Benefit (Optional) Rs.35,000 – Maternity Benefit

Rs.25,000-New Born Cover

Rs.50,000 – Maternity Benefit

Rs.50,000-New Born Cover

Rs. 75,000 and 1 lakh (  based on the SI Opted) N/A
Domestic air ambulance NA NA 1 lakh and 2 lakhs (  based on the SI Opted) NA
Convalescence Benefit NA Rs.10,000

( if hospitalization is for more than 10 days)

Rs. 15,000 and Rs. 20,000 (  based on the SI Opted) NA
Emergency Surface Ambulance Charges Rs. 3000 Rs. 3000 Rs. 3000 Rs. 1500 – SI 3 Lakhs

Rs. 2000 – SI 4 Lakhs

Rs.  1500 – SI 5 Lakhs

No Claim Bonus As per the Annexure As per the Annexure As per the Annexure 5 to 25 percent renewal discount
Out-patient Dental Emergency Treatment (In accidental cases only) NA Rs. 5000 if SI is 20L and 30 L

Rs. 7500 if SI is 30L and above

NA
Annual Health Check-up Basic Extended Comprehensive Once in 4 years
Out-patient Emergency Treatment for Accidents NA Rs. 2500 Rs. 10,000 NA

 

Critical Illness Cover (Add-on benefit) Should not be more than the SI opted Should not be more than the SI opted Should not be more than the SI opted Additional 100 percent Sum Insured on hospitalization expenses
The basis of payment Lump sum payment Lump sum payment Lump sum payment Reimbursement
Hospital Allowance in Cash  (Add -on) Option of Rs.500 , 1000 / day Option of Rs.500,1000,2000 / day Option of Rs.500, 1000,2000,3000 / day Rs. 250/day – SI 3 Lakhs

Rs.350/day – SI 4 Lakhs

Rs.  350/day  – SI 5 Lakhs

Accompanying Person Expenses NA NA NA Rs. 250 for five days after 3 days of hospitalization
Inpatient Physiotherapy NA NA NA 1 percent – SI 4 Lakhs
Home Nursing (deductibles applicable) Not Covered Not Covered Not Covered Rs.250/day – SI 4 Lakhs

 

Dread disease Recuperation ( maximum 45 days) Not Covered Not Covered Not Covered Rs. 200/day – SI 3 Lakhs

Rs.300/day – SI 4 Lakhs

Rs.  200/day  – SI 5 Lakhs

Parent Accommodation as Companion for Child: Not Covered Not Covered Not Covered Rs.250/day – SI 4 Lakhs

( applicable for 10 days post 3 days)

Types of Bharti AXA Health Insurance Plans

There are two major health insurance plans provided by Bharti AXA Health Insurance –

  • Smart Health Insurance Plan – This plan covers hospitalization expenses with up to Rs. 5 lakhs.
  • Smart Super Health Insurance Policy – Comes in three variants – Value plan, Classic and Uber Plan with sum assured up to Rs. 100 lakhs.

Claim Process of Bharti AXA Health Insurance

The dedicated claim handling team makes it a hassle-free affair to claim for Bharti AXA Health Insurance plans. The details are mentioned below –

Cashless Claim Settlement Process

Cashless treatment can only be availed at the network hospitals that are listed by the insurance company. You need to inform the insurance company with 24 hours of hospitalization if it is unplanned.  For planned hospital admission, inform your health insurance provider four days in advance.

Steps for Bharti AXA health insurance claims are as follows-

  • Show your health card at the help desk of the network hospital
  • Your identity details will be then verified by the hospital
  • You need to submit your pre-authorization form as duly filled and signed by you to the TPA of the insurance company
  • Once a pre-authorization request is verified, the approval letter will be sent over mail to the network hospital
  • The cashless treatment request will be then processed and the network hospital will settle the medical bills directly
  • If your request for cashless claim settlement is denied, then you will be reimbursed for your hospital expenses, once you are discharged

Reimbursement Claim Settlement Process

For treatment in a non-network hospital – then you shall inform your insurer within 2 days of hospitalization. The process is as follows –

  • Once the treatment is done, collect all your hospital bills, invoices etc. Once you are discharged, take your exit file with all the treatment details, medical bills, discharge summary, doctor’s prescription, pharmacy bills etc.
  • Submit the duly filled reimbursement claim form along with the original copy of the medical documents to the insurance company
  • Once the complete verification is done, and approval is granted, the proposer or insured person will receive the claim amount in twenty one days of receipt of all the necessary documents
  • If the insurance company denies your claim request, then you will receive a rejection letter in which the reason for rejection will be mentioned as well.

Bharti AXA Health Insurance Renewal

You can easily renew your policy online by following steps

  • Enter your previous health insurance policy number
  • Enter your policy expiry date
  • Enter your name
  • Email id
  • Mobile number
  • Agree to get a callback and click on continue
  • One of their representatives will get in touch with you and help you renew your policy. You can opt for additional benefits and increase the sum assured while renewing the policy.

Before renewal, it is suggested that you read Bharti AXA medical insurance reviews online and then make the purchase.

Bharti AXA Health Insurance Policy – Inclusions

Here are some of the common inclusions of Bharti AXA Health Insurance policy-

  • Daycare treatments where hospitalization is not required for more than 24 hours.  It includes eye surgery, dialysis, and other common daycare surgeries as mentioned in the policy documents.
  • Pre and post hospitalization expenses as per the policy wordings
  • Ayush treatment up to the sum insured limit
  • Room rent expenses as specified in the documents
  • Organ donor expense up to SI
  • Optional maternity benefit
  • Annual health check-up facility
  • Hospital cash allowance ( optional benefit)
  • Critical illness Insurance cover (add-on benefit) – The policy covers cancer (as specified in the plan), heart attack (first), open chest bypass grafting, open heart replacement, stroke, Aortic Surgery, lung and liver disease (last stage), major burns, Fulminant Hepatitis, kidney failure, major organ, Motor neuron disease, bone marrow transplant, coma, pulmonary hypertension, Aplastic anemia, bacterial meningitis, Coronary artery disease, Multiple Sclerosis and terminal illness.

*Note:  The inclusions may vary as per the plan opted. Please refer to the policy wordings for more details.  

Bharti AXA Health Insurance Policy – Exclusions:

Bharti AXA mediclaim policy does not cover the following:

  • Any health injuries or illnesses resulting due to war operations, seizure, hostilities, or an act of the foreign enemy.
  • Injuries/diseases while serving as a member of the police force or military
  • Any terrorist accident or act of terrorism
  • Medical treatment required after nuclear radiations or ionization or any other nuclear perils
  • Injuries directly or indirectly related to adventurous sports
  • Dental surgeries ( unless it is an accidental case)
  • Hormone replacement therapies, birth control procedures, and infertility treatments
  • Health ailments caused due to consumption of alcohol or drugs
  • Weight management treatment
  • Treatment for HIV and AIDS
  • Cost of vitamins, supplements, spectacles and hearing aids
  • Treatment for mental disorders
  • Any treatment received outside India
  • Cost of donor treatment/screening

 Note:  For the detailed list of exclusions, please refer to the policy wordings.

 Benefits of Bharti AXA Health Insurance

  • Renewal Discount –The insurance company provides 5% to 35% of renewal discount on the premium amount, or every claim free year.
  • Tax Exemption Benefits –The total premium which goes on a yearly basis helps you save tax up to Rs. 55,000 as per Indian Income Tax Act, 1961.
  • Additional Health Check-up Facilities –As part of certain insurance plans, the insured person can get reimbursements on health-checkup, on completion of a certain specified period.
  • Pre- Policy Medical Screening – Bharti AXA health insurance will reimburse your expenses incurred on health check-ups required before purchasing the policy. This is subjected to the limits, as specified in the policy documents.
  • Free-Look Period –If you purchase a health insurance policy from Bharti AXA, then you are given a chance to evaluate your policy benefits and limitations. If you are dissatisfied, you can easily cancel the policy in the free-look period of 15 days.  Even your premium amount will be refunded along with medical screening cost and stamp duty charges. It is not applicable when the policy is renewed subsequently.
  • Third Party Administrator Services – On purchasing the health insurance plan you will be serviced by the TPA or Third Party Administrator Department, that will assist you for cashless claim settlement in panel hospitals and medical reimbursement in non-network hospitals
  • Compensation of Medical Examination Fees –If the company accepts your proposal for the same, then 50% of the medical examination costs ( registered hospitals or diagnostic facilities) will be reimbursed  by the insurer
  • Easy Portability – You can easily port out from your existing health insurance plan to Bharti AXA health insurance plan, if there has been no break while paying the premium of the current policy or if you have good customer record with your insurance company.

How is Health Insurance Premium Calculated for Bharti AXA?

Bharti AXA health insurance premium is based on the following factors-

  • Sum Insured
  • of family members that are covered
  • Age of the senior most member
  • Policy type – Basic plan, Premium plan or Optimum plan

You can also use online health insurance premium calculator to know the premium amount.

How to Reduce Your Bharti AXA Health Insurance Premium Amount

  • Purchase The Policy At The Right Age

With age, health risks also increase. And the amount of insurance premium also increases for people who are more in age. If you become an early bird, you can actually save a lot on premium amount and safeguard yourself from health risks in a timely manner.

  • No-Claim Bonus Benefit

You can save up to 25 % as a no-claim bonus for the years that you have not made a health insurance claim. It is known as the policy renewal discount.

  • Opt For a Family Floater Plan

A family floater health insurance plan is an ideal choice, if you have young members in the family who are dependent on you. All can be insured under a single sum insured, as buying an individual plan can prove to be a costly affair.

  • Choose a Healthy Lifestyle

This may sound cliché, but smokers and alcohol addicts are more vulnerable to diseases. A clear medical history will help you save on premium amount.

Why Buy Health Insurance from Bharti AXA?

  • There is no requirement of co-payment
  • Certain plans provide unlimited hospital room rent
  • You can avail cashless hospitalization in more than 4500 network hospitals throughout India
  • There is flexibility to choose the plan and you can avail comprehensive medical cover up to Rs. 1 crore
  • Seamless online policy issuance process. More than 1.3 million insurance policies have been issued by Bharti Axa
  • Lifelong policy renewal facility
  • You can avail tax-saving benefits up to Rs. 55,000 under Section 80D
  • The insurance company has 101 branches within India
  • You can avail 24*7 customer care support

Simple online purchase process in 3 steps-

  1. Select the suitable health insurance plan from their website.
  2. Fill all the necessary details and initiate the payment process
  3. Once payment is done, you will receive your Bharti AXA medical insurance plan details and invoice on your registered email id.

Documents Required for Bharti AXA Health Insurance

  1. Claim form to be duly signed by the policyholder and the concerned doctor
  2. Discharge summary (original)
  3. Original receipts, bills with a detailed break-up of the costs
  4. Doctor’s prescription, consultation report and lab reports
  5. In case of a medical history, a letter/statement from the treating doctor is required
  6. In case of an accident ( a letter from the treating doctor and Police FIR copy is required)
  7. In case of an accident, police FIR copy and a letter from the treating doctor related to intoxication and any other condition is required
  8. In case  of a non-network hospital  registration certificate of the hospital is required
  9. In case of delay in claims, a letter from the policyholder stating the reason for the delay is required
  10. Health ID card/ copy of Bharti AXA health insurance policy/ TPA ID Card, along with address and ID proof of the proposer and patient is required
  11. Cancelled cheque ( as the case may be)

Once the documents are reviewed, you will receive your payment within twenty one days of the submission of the documents.  If the medical condition is not covered under Bharti AXA mediclaim policy, you will receive a letter stating the reason for rejection.

Eligibility Criteria of Bharti AXA Health Insurance

  • There is no maximum age to buy Bharti AXA Health Insurance policy
  • Up to 4 family members can be covered in a family floater policy including your spouse and dependent children up to 23 yrs. of age.
  • Pre-existing illnesses will be included after 4 years of waiting period
  • There are plans offering coverage from 91 days and 18 years also
  • The policy allows lifetime renewability

Bharti AXA Health Insurance FAQs

Q. Can I purchase Bharti AXA health insurance online?

Ans. Yes, you can buy it online in 3 simple steps-

  1. Choose an appropriate plan from the insurer’s site
  2. After filling the necessary information, you can make the payment online
  3. The policy will be mailed to you on your registered email id.

Q. What are the sum insured options in Bharti AXA Smart Health Insurance Policy?

Ans. You can opt for coverage for Rs. 3 lakhs, 4 lakhs and 5 lakhs in a smart health plan.

Q. Is health card provided by Bharti AXA?

Ans. Yes, when you purchase a policy, the insurer gives you a health card. You need to provide this health card at the network hospital before the hospitalization.  It is required to avail cashless claim settlement facility.

The health card also has the contact details of the TPAs, whom you can contact at the time of a medical emergency to seek assistance.

Q. What are the sum insured options in Bharti AXA Smart Super Health Insurance Plan?

Ans. The plan offers a wide range of sum insured options between Rs. 5 lacs and Rs. 1 Crore.

Q. How to reimburse my health claim with Bharti AXA?

Ans.To reimburse a health insurance claim the process goes as follows-

  • You get admitted to the hospital
  • You take the health treatment
  • You pay all the hospital bills
  • Get all the receipts and documents in original
  • Submits the claim form and all the required documents to the TPA department
  • Once all the documents are reviewed by the TPA, the amount will be reimbursed within 21 days of document submission.

In case of rejection, the insurer will send you a letter stating the reasons for claim rejection.

Q. Are pre and post hospitalization expenses covered in Bharti AXA health insurance?

Ans. Bharti AXA Smart Super Health Insurance Plan compensates 60 days of pre-hospitalization expenses and post-hospitalization expense for 90 days. Whereas in Smart Health Insurance Plan the limit for pre and post hospitalization expenses is 40 days and 60 days respectively.

Q. What is the age-limit to cover dependent children in Bharti AXA mediclaim policy?

Ans.You can cover yourself, your spouse and two dependent children up to a maximum age of 23 years.  The plan offers lifetime renewability option.

Q. What is the benefit of buying Bharti AXA family floater health insurance plan?

Ans. In Bharti AXA family floater health insurance plan all the family members are covered including the spouse and children below 23 years of age. Single premium needs to be paid and all the members are covered in a single plan. The premium is based on the age of the eldest member of the family.